Florida Senate - 2014                        COMMITTEE AMENDMENT
       Bill No. SB 734
       
       
       
       
       
       
                                Ì657682FÎ657682                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  04/06/2014           .                                
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       recommended the following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Paragraphs (d) and (e) of subsection (3) and
    6  subsections (4), (5), and (6) of section 1004.435, Florida
    7  Statutes, are amended to read:
    8         1004.435 Cancer control and research.—
    9         (3) DEFINITIONS.—The following words and phrases when used
   10  in this section have, unless the context clearly indicates
   11  otherwise, the meanings given to them in this subsection:
   12         (d) “Fund” means the Florida Cancer Control and Research
   13  Fund established by this section.
   14         (e) “Qualified nonprofit association” means any
   15  association, incorporated or unincorporated, that has received
   16  tax-exempt status from the Internal Revenue Service.
   17         (4) FLORIDA CANCER CONTROL AND RESEARCH ADVISORY COUNCIL;
   18  CREATION; COMPOSITION.—
   19         (a) There is created within the H. Lee Moffitt Cancer
   20  Center and Research Institute, Inc., the Florida Cancer Control
   21  and Research Advisory Council. The council shall consist of 15
   22  35 members, which includes the chairperson, all of whom must be
   23  residents of this state. The State Surgeon General or his or her
   24  designee within the Department of Health shall be one of the 15
   25  members. All Members, except those appointed by the Governor,
   26  the Speaker of the House of Representatives, or and the
   27  President of the Senate, must be appointed by the chief
   28  executive officer of the institution or organization
   29  represented, or his or her designee Governor. At least one of
   30  the members appointed by the Governor must be 60 years of age or
   31  older. One member must be a representative of the American
   32  Cancer Society; one member must be a representative of the
   33  Florida Tumor Registrars Association; one member must be a
   34  representative of the Sylvester Comprehensive Cancer Center of
   35  the University of Miami; one member must be a representative of
   36  the Department of Health; one member must be a representative of
   37  the University of Florida Shands Cancer Center; one member must
   38  be a representative of the Agency for Health Care
   39  Administration; one member must be a representative of the
   40  Florida Nurses Association who specializes in the field of
   41  oncology and is not from an institution or organization already
   42  represented on the council; one member must be a representative
   43  of the Florida Osteopathic Medical Association who specializes
   44  in the field of oncology; one member must be a representative of
   45  the American College of Surgeons; one member must be a
   46  representative of the School of Medicine of the University of
   47  Miami; one member must be a representative of the College of
   48  Medicine of the University of Florida; one member must be a
   49  representative of NOVA Southeastern College of Osteopathic
   50  Medicine; one member must be a representative of the College of
   51  Medicine of the University of South Florida; one member must be
   52  a representative of the College of Public Health of the
   53  University of South Florida; one member must be a representative
   54  of the Florida Society of Clinical Oncology; one member must be
   55  a representative of the Florida Obstetric and Gynecologic
   56  Society who has had training in the specialty of gynecologic
   57  oncology; one member must be a representative of the Florida
   58  Ovarian Cancer Alliance Speaks (FOCAS) organization; one member
   59  must be a member representative of the Florida Medical
   60  Association who specializes in the field of oncology and who
   61  represents a cancer center not already represented on the
   62  council; one member must be a member of the Florida Pediatric
   63  Society; one member must be a representative of the Florida
   64  Radiological Society; one member must be a representative of the
   65  Florida Society of Pathologists; one member must be a
   66  representative of the H. Lee Moffitt Cancer Center and Research
   67  Institute, Inc.; one member must be a member of the Florida
   68  Hospital Association who specializes in the field of oncology
   69  and who represents a comprehensive cancer center not already
   70  represented on the council; one member must be a representative
   71  of the Association of Community Cancer Centers; one member must
   72  specialize in pediatric oncology research or clinical care
   73  appointed by the Governor; one member must specialize in
   74  oncology clinical care or research appointed by the President of
   75  the Senate; one member must be a current or former cancer
   76  patient or a current or former caregiver to a cancer patient
   77  appointed by the Speaker of the House of Representatives three
   78  members must be representatives of the general public acting as
   79  consumer advocates; one member must be a member of the House of
   80  Representatives appointed by the Speaker of the House of
   81  Representatives; and one member must be a member of the Senate
   82  appointed by the President of the Senate; one member must be a
   83  representative of the Florida Dental Association; one member
   84  must be a representative of the Florida Hospital Association;
   85  one member must be a representative of the Association of
   86  Community Cancer Centers; one member shall be a representative
   87  from a statutory teaching hospital affiliated with a community
   88  based cancer center; one member must be a representative of the
   89  Florida Association of Pediatric Tumor Programs, Inc.; one
   90  member must be a representative of the Cancer Information
   91  Service; one member must be a representative of the Florida
   92  Agricultural and Mechanical University Institute of Public
   93  Health; and one member must be a representative of the Florida
   94  Society of Oncology Social Workers. Of the members of the
   95  council appointed by the Governor, At least four of the members
   96  10 must be individuals who are minority persons as defined by s.
   97  288.703.
   98         (b) The terms of the members shall be 4 years from their
   99  respective dates of appointment with the option of renewal.
  100         (c) A chairperson shall be selected by the council
  101  appointed by the Governor for a term of 2 years. The chairperson
  102  shall appoint an executive committee of no fewer than three
  103  persons to serve at the pleasure of the chairperson. This
  104  committee will prepare material for the council but make no
  105  final decisions.
  106         (d) The council shall meet no less than semiannually at the
  107  call of the chairperson or, in his or her absence or incapacity,
  108  at the call of the State Surgeon General. Eight Sixteen members
  109  constitute a quorum for the purpose of exercising all of the
  110  powers of the council. A vote of the majority of the members
  111  present is sufficient for all actions of the council.
  112         (e) The council members shall serve without pay. Pursuant
  113  to the provisions of s. 112.061, the council members may be
  114  entitled to be reimbursed for per diem and travel expenses by
  115  the institution or organization the member represents. If a
  116  member is not affiliated with an institution or organization,
  117  the member shall be reimbursed for travel expenses by the H. Lee
  118  Moffitt Cancer Center and Research Institute, Inc.
  119         (f) No member of the council shall participate in any
  120  discussion or decision to recommend grants or contracts to any
  121  qualified nonprofit association or to any agency of this state
  122  or its political subdivisions with which the member is
  123  associated as a member of the governing body or as an employee
  124  or with which the member has entered into a contractual
  125  arrangement.
  126         (f)(g) The council may prescribe, amend, and repeal bylaws
  127  governing the manner in which the business of the council is
  128  conducted.
  129         (g)(h) The council shall advise the Board of Governors, the
  130  State Surgeon General, and the Legislature with respect to
  131  cancer control and research in this state.
  132         (h)(i) The council shall approve each year a program for
  133  cancer control and research to be known as the “Florida Cancer
  134  Control and Research Plan” which shall be consistent with the
  135  State Health Plan and integrated and coordinated with existing
  136  programs in this state.
  137         (i)(j) The council shall collaborate with the Florida
  138  Biomedical Research Advisory Council to formulate and annually
  139  review and recommend to the State Surgeon General a statewide
  140  research plan. Additionally, the council shall develop and
  141  annually review a statewide “Florida Cancer Treatment Plan” plan
  142  for the care and treatment of persons suffering from cancer. The
  143  council shall and recommend the establishment of standard
  144  requirements for the organization, equipment, and conduct of
  145  cancer units or departments in hospitals and clinics in this
  146  state. The council may recommend to the State Surgeon General
  147  the designation of cancer units following a survey of the needs
  148  and facilities for treatment of cancer in the various localities
  149  throughout the state. The State Surgeon General shall consider
  150  the plans plan in developing departmental priorities and funding
  151  priorities and standards under chapter 395.
  152         (j)(k) The council is responsible for including in the
  153  Florida Cancer Control and Research Plan recommendations for the
  154  coordination and integration of medical, nursing, paramedical,
  155  lay, and other plans concerned with cancer control and research.
  156  Committees shall be formed by the council so that the following
  157  areas will be established as entities for actions:
  158         1. Cancer plan evaluation: tumor registry, data retrieval
  159  systems, and epidemiology of cancer in the state and its
  160  relation to other areas.
  161         2. Cancer prevention.
  162         3. Cancer detection.
  163         4. Cancer patient management: treatment, rehabilitation,
  164  terminal care, and other patient-oriented activities.
  165         5. Cancer education: lay and professional.
  166         6. Unproven methods of cancer therapy: quackery and
  167  unorthodox therapies.
  168         7. Investigator-initiated project research.
  169         (l) In order to implement in whole or in part the Florida
  170  Cancer Plan, the council shall recommend to the Board of
  171  Governors or the State Surgeon General the awarding of grants
  172  and contracts to qualified profit or nonprofit associations or
  173  governmental agencies in order to plan, establish, or conduct
  174  programs in cancer control or prevention, cancer education and
  175  training, and cancer research.
  176         (m) If funds are specifically appropriated by the
  177  Legislature, the council shall develop or purchase standardized
  178  written summaries, written in layperson’s terms and in language
  179  easily understood by the average adult patient, informing actual
  180  and high-risk breast cancer patients, prostate cancer patients,
  181  and men who are considering prostate cancer screening of the
  182  medically viable treatment alternatives available to them in the
  183  effective management of breast cancer and prostate cancer;
  184  describing such treatment alternatives; and explaining the
  185  relative advantages, disadvantages, and risks associated
  186  therewith. The breast cancer summary, upon its completion, shall
  187  be printed in the form of a pamphlet or booklet and made
  188  continuously available to physicians and surgeons in this state
  189  for their use in accordance with s. 458.324 and to osteopathic
  190  physicians in this state for their use in accordance with s.
  191  459.0125. The council shall periodically update both summaries
  192  to reflect current standards of medical practice in the
  193  treatment of breast cancer and prostate cancer. The council
  194  shall develop and implement educational programs, including
  195  distribution of the summaries developed or purchased under this
  196  paragraph, to inform citizen groups, associations, and voluntary
  197  organizations about early detection and treatment of breast
  198  cancer and prostate cancer.
  199         (k)(n) The council shall have the responsibility to advise
  200  the Board of Governors and the State Surgeon General on methods
  201  of enforcing and implementing laws already enacted and concerned
  202  with cancer control, research, and education.
  203         (l)(o) The council may recommend to the Board of Governors
  204  or the State Surgeon General rules not inconsistent with law as
  205  it may deem necessary for the performance of its duties and the
  206  proper administration of this section.
  207         (m)(p) The council shall formulate and put into effect a
  208  continuing educational program for the prevention of cancer and
  209  its early diagnosis and disseminate to hospitals, cancer
  210  patients, and the public information concerning the proper
  211  treatment of cancer.
  212         (n)(q) The council shall be physically located at the H.
  213  Lee Moffitt Cancer Center and Research Institute, Inc., at the
  214  University of South Florida.
  215         (o)(r) The council shall select, by majority vote, seven
  216  members of the council who must combine with six members of the
  217  Biomedical Research Advisory Council to form a joint committee
  218  to develop performance measures, a rating system, a rating
  219  standard, and an application form for the Cancer Center of
  220  Excellence Award created in s. 381.925.
  221         (p)(s) On February 15 of each year, the council shall
  222  report to the Governor and to the Legislature.
  223         (5) RESPONSIBILITIES OF THE BOARD OF GOVERNORS, THE H. LEE
  224  MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, INC., AND THE
  225  STATE SURGEON GENERAL.—
  226         (a) The Board of Governors or the State Surgeon General,
  227  after consultation with the council, shall award grants and
  228  contracts to qualified nonprofit associations and governmental
  229  agencies in order to plan, establish, or conduct programs in
  230  cancer control and prevention, cancer education and training,
  231  and cancer research.
  232         (b) The H. Lee Moffitt Cancer Center and Research
  233  Institute, Inc., shall provide such staff, information, and
  234  other assistance as reasonably necessary for the completion of
  235  the responsibilities of the council.
  236         (c) The department may furnish to citizens of this state
  237  who are afflicted with cancer financial aid to the extent of the
  238  appropriation provided for that purpose in a manner which in its
  239  opinion will afford the greatest benefit to those afflicted and
  240  may make arrangements with hospitals, laboratories, or clinics
  241  to afford proper care and treatment for cancer patients in this
  242  state.
  243         (6) FLORIDA CANCER CONTROL AND RESEARCH FUND.—
  244         (a) There is created the Florida Cancer Control and
  245  Research Fund consisting of funds appropriated therefor from the
  246  General Revenue Fund and any gifts, grants, or funds received
  247  from other sources.
  248         (b) The fund shall be used exclusively for grants and
  249  contracts to qualified nonprofit associations or governmental
  250  agencies for the purpose of cancer control and prevention,
  251  cancer education and training, cancer research, and all expenses
  252  incurred in connection with the administration of this section
  253  and the programs funded through the grants and contracts
  254  authorized by the State Board of Education or the State Surgeon
  255  General.
  256         Section 2. Subsections (1) and (2) of section 458.324,
  257  Florida Statutes, are amended to read:
  258         458.324 Breast cancer; information on treatment
  259  alternatives.—
  260         (1) DEFINITION.—As used in this section, the term
  261  “medically viable,” as applied to treatment alternatives, means
  262  modes of treatment generally considered by the medical
  263  profession to be within the scope of current, acceptable
  264  standards, including treatment alternatives described in the
  265  written summary prepared by the Florida Cancer Control and
  266  Research Advisory Council in accordance with s. 1004.435(4)(m).
  267         (2) COMMUNICATION OF TREATMENT ALTERNATIVES.—
  268         (a) Each physician treating a patient who is, or in the
  269  judgment of the physician is at high risk of being, diagnosed as
  270  having breast cancer shall inform such patient of the medically
  271  viable treatment alternatives available to such patient; shall
  272  describe such treatment alternatives; and shall explain the
  273  relative advantages, disadvantages, and risks associated with
  274  the treatment alternatives to the extent deemed necessary to
  275  allow the patient to make a prudent decision regarding such
  276  treatment options. In compliance with this subsection,:
  277         (a) the physician may, in his or her discretion,:
  278         1. orally communicate such information directly to the
  279  patient or the patient’s legal representative;
  280         2. Provide the patient or the patient’s legal
  281  representative with a copy of the written summary prepared in
  282  accordance with s. 1004.435(4)(m) and express a willingness to
  283  discuss the summary with the patient or the patient’s legal
  284  representative; or
  285         3. Both communicate such information directly and provide a
  286  copy of the written summary to the patient or the patient’s
  287  legal representative for further consideration and possible
  288  later discussion.
  289         (b) In providing such information, the physician shall take
  290  into consideration the emotional state of the patient, the
  291  physical state of the patient, and the patient’s ability to
  292  understand the information.
  293         (c) The physician may, in his or her discretion and without
  294  restriction, recommend any mode of treatment which is in his or
  295  her judgment the best treatment for the patient.
  296  
  297  Nothing in this subsection shall reduce other provisions of law
  298  regarding informed consent.
  299         Section 3. Subsections (1) and (2) of section 459.0125,
  300  Florida Statutes, are amended to read:
  301         459.0125 Breast cancer; information on treatment
  302  alternatives.—
  303         (1) DEFINITION.—As used in this section, the term
  304  “medically viable,” as applied to treatment alternatives, means
  305  modes of treatment generally considered by the medical
  306  profession to be within the scope of current, acceptable
  307  standards, including treatment alternatives described in the
  308  written summary prepared by the Florida Cancer Control and
  309  Research Advisory Council in accordance with s. 1004.435(4)(m).
  310         (2) COMMUNICATION OF TREATMENT ALTERNATIVES.—
  311         (a) It is the obligation of every physician treating a
  312  patient who is, or in the judgment of the physician is at high
  313  risk of being, diagnosed as having breast cancer to inform such
  314  patient of the medically viable treatment alternatives available
  315  to such patient; to describe such treatment alternatives; and to
  316  explain the relative advantages, disadvantages, and risks
  317  associated with the treatment alternatives to the extent deemed
  318  necessary to allow the patient to make a prudent decision
  319  regarding such treatment options. In compliance with this
  320  subsection,:
  321         (a) the physician may, in her or his discretion,:
  322         1. orally communicate such information directly to the
  323  patient or the patient’s legal representative;
  324         2. Provide the patient or the patient’s legal
  325  representative with a copy of the written summary prepared in
  326  accordance with s. 1004.435(4)(m) and express her or his
  327  willingness to discuss the summary with the patient or the
  328  patient’s legal representative; or
  329         3. Both communicate such information directly and provide a
  330  copy of the written summary to the patient or the patient’s
  331  legal representative for further consideration and possible
  332  later discussion.
  333         (b) In providing such information, the physician shall take
  334  into consideration the emotional state of the patient, the
  335  physical state of the patient, and the patient’s ability to
  336  understand the information.
  337         (c) The physician may, in her or his discretion and without
  338  restriction, recommend any mode of treatment which is in the
  339  physician’s judgment the best treatment for the patient.
  340  
  341  Nothing in this subsection shall reduce other provisions of law
  342  regarding informed consent.
  343         Section 4. This act shall take effect July 1, 2014.
  344  
  345  ================= T I T L E  A M E N D M E N T ================
  346  And the title is amended as follows:
  347         Delete everything before the enacting clause
  348  and insert:
  349                        A bill to be entitled                      
  350         An act relating to cancer control and research;
  351         amending s. 1004.435, F.S.; revising definitions;
  352         revising the membership of the Florida Cancer Control
  353         and Research Advisory Council and selection of the
  354         council chairperson; authorizing renewal of member
  355         terms; revising compensation of council members;
  356         renaming the Florida Cancer Plan; requiring the
  357         council to collaborate with the Florida Biomedical
  358         Research Advisory Council to formulate and review a
  359         statewide research plan; requiring the council to
  360         develop and review a statewide treatment plan;
  361         deleting council, Board of Governors, and State
  362         Surgeon General duties relating to the awarding of
  363         grants and contracts for cancer-related programs;
  364         deleting council duties relating to the development of
  365         written summaries of treatment alternatives; deleting
  366         financial aid provisions and the Florida Cancer
  367         Control and Research Fund; amending ss. 458.324 and
  368         459.0125, F.S.; conforming provisions; providing an
  369         effective date.